Clinical Scorecard: Temperature Exposure and Heart Failure: Understanding the Exposure–Response Relationship

At a Glance

Key Highlights

• In a 2007–2022 study, approximately 1 million adults aged 65 years and older experienced approximately 1.5 million HF hospitalizations. Compared with 75 °F, moderate cold at the 25th percentile was associated with 16% higher odds of hospitalization, and extreme cold at the 5th percentile with 12% higher odds.
• Associations between moderate cold exposure and HF hospitalization varied across US climate regions.
• Estimates for hot temperatures were imprecise and crossed the null, except in the South, where extreme heat was associated with 5% lower odds of HF hospitalization.
• Daily mean temperature may not capture physiologically relevant heat stress; heat index or wet-bulb globe temperature may better represent combined environmental exposures.
• The source discusses policy changes to support capacity building and adaptability, but the provided text ends before specifying interventions.

Guideline-Based Recommendations

Diagnosis

• The article does not provide diagnostic criteria for HF.

Management

• The provided source discusses policy changes to support capacity building and adaptability but does not specify management recommendations.

Monitoring & Follow-up

• The article does not specify a clinical monitoring protocol.

Risks

• Moderate cold at the 25th percentile was associated with increased odds of HF hospitalization; the source gives regional examples of 30 °F in West North Central and 54 °F in West.
• Extreme-heat estimates for HF hospitalization were imprecise; death may compete with hospitalization and contribute to an apparently protective association.
• Regional estimates using a fixed 75 °F reference temperature are not directly comparable because that reference represents different temperature percentiles across regions.

Patient & Prescribing Data

Adults aged 65 years and older; the study used a 50% random sample of Medicare fee-for-service beneficiaries. Approximately 1 million patients experienced approximately 1.5 million HF hospitalizations.

No medication prescribing data are reported. The provided source discusses temperature exposure and policy needs, but does not specify treatment or exposure-reduction interventions.

Clinical Best Practices

• The article reports an association between moderate cold exposure and HF hospitalization among older adults; it does not provide clinical practice recommendations.
• Consider that daily mean ambient temperature may not reflect personal exposure or physiologically relevant heat stress.
• Interpret regional temperature associations cautiously when studies use a common reference temperature that represents different regional percentiles.

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